Introduction: Patients with seronegative spondyloarthritis (SpA) – psoriatic arthritis (PsA) and ankylosing spondylitis (AS) – have a higher risk of cardiovascular morbidity and mortality. The aim of the present study was to evaluate the incidence and type of dyslipidemia, a potent atherosclerosis risk factor, in SpA patients.Material and methods: It was a two-center, case-control study. Patients diagnosed with PsA and AS aged 23–60 years, with disease duration < 10 years, were enrolled. The inflammatory activity, serum levels of C-reactive protein (CRP) and lipid profile were evaluated in each patient. In patients > 40 years old, the 10-year risk of fatal cardiovascular disease (CVD), using Systematic Coronary Risk Evaluation (SCORE), was estimated.Results: In total 79 patients with SpA were included in the study, with PsA diagnosed, n = 39 (mean age 45.1 ±9.6 years; 21, 53.9%, women), and with AS diagnosed, n = 40 (age 40.3 ±9.5; 12.3%, women), control group (CG): n = 88 (age 42.3 ±8.1; 42, 47.7% women). Based on the interview and laboratory tests, dyslipidemia was diagnosed in 19 (47.5%) patients with AS and in 28 (71.8%) patients with PsA. Most patients had hypercholesterolemia or mixed hyperlipidemia. Types of dyslipidemia were similar. In SpA patients (PsA and AS), the level of triglycerides (TG) and atherogenic index (AI) were significantly higher than in the CG, respectively TG in SpA: 116 (83–156) and in the CG: 91.2 (72.6–134.6) mg/dl, p = 0.0182; AI in SpA: 3.77 ±1.26 and in the CG: 2.58 ±1.27, p < 0.0001. The low-density cholesterol (LDL) level was significantly lower in SpA patients than in the CG, SpA: 109.1 ±29.4 vs. CG: 125.2 ±35.9 mg/dl, p = 0.0023. There was a strong negative correlation between CRP levels and HDL cholesterol levels in patients with PsA, rho = 0.42, p = 0.0132. Mean SCORE values were 2.33% in PsA patients and 2.38% in AS patients, which results in moderate 10-year risk of death from CVD.Conclusions: In young patients with spondyloarthropathies, inflammatory factors significantly influence dyslipidemia patterns, which result in higher TG and lower LDL cholesterol levels. In patients with PsA, dyslipidemia was diagnosed more often than in patients with AS.

Exercise capacity is frequently reduced in patients with hypertrophic cardiomyopathy (HCM), yet structured training has historically been limited due to concerns about arrhythmias and sudden cardiac death. Recent data suggest that supervised, individualized exercise may be safe in selected patients; however, evidence for hybrid cardiac telerehabilitation (HCT) in non-obstructive HCM remains lacking. To evaluate the efficacy and safety of a 12-week hybrid cardiac telerehabilitation programme in patients with non-obstructive HCM and preserved left ventricular ejection fraction. In this single-center randomized controlled trial, 60 patients were allocated (1:1) to HCT or usual care. The HCT program consisted of supervised center-based exercise sessions combined with remotely monitored home training. The primary endpoint was the change in peak oxygen uptake (pVO2) after 3 months. Secondary endpoints included changes in 6-minute walk distance, perceived health status, and safety parameters. Follow-up continued for 12 months after program completion. Fifty-eight patients completed the 3-month assessment (HCT n = 28; control n = 30). HCT resulted in a significantly greater improvement in pVO2 compared with usual care (between-group difference: +1.35 ml/kg/min; P <0.01). Additional significant improvements were observed in 6-minute walk test distance. Perceived health status improved in both groups, with a greater increase in the HCT group. No serious adverse events occurred, and adherence to the training program was high. HCT is feasible, safe, and effective in improving functional capacity and perceived health status in carefully selected patients with non-obstructive HCM. These findings support the use of structured, telemonitored exercise training in low-risk HCM populations, although larger multicenter trials are needed to confirm generalizability.

Hypertrophic cardiomyopathy (HCM) is the most common congenital disease increasing the risk of sudden cardiac death. For many years, HCM patients were excluded from exercise training. However, there are data showing that patients with HCM undergoing supervised exercise training could improve physical performance without serious adverse events. A project was designed as a randomized clinical trial to assess the effectiveness and safety of hybrid cardiac rehabilitation (HCR)—a combination of hospital-based cardiac rehabilitation (1 month) with a new form of home-based telemonitored cardiac rehabilitation (2 months) in HCM patients without left ventricular (LV) outflow tract obstruction and preserved systolic function. Sixty patients who fulfil the inclusion criteria have been randomly assigned (1:1) to either HCR plus usual care (training group) or usual care only (control group). The primary endpoint is a functional capacity evaluated by peak oxygen uptake (pVO₂). Secondary endpoints include workload time during the cardiopulmonary exercise testing, a six-minute walk test distance, NT-pro BNP level, echocardiographic parameters of the left ventricular diastolic function (E/A, E/e’, myocardial strain rate), right ventricular systolic pressure, a gradient in the LV outflow tract, and quality of life. The tertiary analysis includes safety, acceptance and adherence to the HCR program. Our research will provide innovative data on the effectiveness and safety of hybrid cardiac rehabilitation in HCM patients without LV outflow tract obstruction and preserved systolic function. Clinical trials registry: ClinicalTrials.gov Identifier NCT03178357.

The most common clinical scenario in which RV is systemic, is dextroposition transposition of the great arteries (dTGA). This is the second most common cyanotic congenital heart disease [2]. Before the arterial switch operation was introduced in 1975 [3], patients with dTGA were treated with the Mustard or Senning procedure, also referred to as the atrial switch operation, where the systemic veins are routed to the subpulmonary morphological left ventricle and the pulmonary veins are routed to the systemic right ventricle [4].The atrial switch operation leaves the RV in a systemic position, leading to gradual RV dysfunction and RV failure [5-8]. In this context, sRV functional reserve and its ability to augment performance with exercise performance is not well studied.